MS. THERESA MARIE WILSON (LICSW) – Clinical Social Worker, NPI 1063816916

MS. THERESA MARIE WILSON (LICSW) is a healthcare provider. based in North easton, Massachusetts. specializing in Clinical Social Worker. They hold the professional credentials LICSW. They hold a License No. 117772 (MA). The NPI Number for MS. THERESA MARIE WILSON (LICSW) is 1063816916

Main info

Female
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
MS. THERESA MARIE WILSON (LICSW)
NPI
1063816916
Phone
(508) 238-9138
Address
138 SUMMER ST
Enumeration Date
21 October 2014
Last Update Date
21 October 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5085845280
Graduation Year
2008 (18 years ago)
PAC ID
0547541427
Group Practice PAC ID
5991776627
Professional Enrollment ID
I20170109001289
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for MS. THERESA MARIE WILSON (LICSW)

  • 138 SUMMER ST

    NORTH EASTON, MA 023562242

    Phone: (508) 238-9138

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-01-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170109001289IClinical Social WorkerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02356)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991776627View full group profile
NameSpecialtyState
Nurse PractitionerMA
Clinical Social WorkerMA
-MA
-MA
Clinical Social WorkerMA
Clinical Social WorkerMA
Clinical Social WorkerMA
Mental Health CounselorMA
Nurse PractitionerMA
-MA

Reviews

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Frequently asked questions

Can I use this page to confirm MS. THERESA MARIE WILSON (LICSW)'s NPI?
Yes. MS. THERESA MARIE WILSON (LICSW) is listed with NPI 1063816916 in the public NPI dataset.
Can I rely on MS. THERESA MARIE WILSON (LICSW) being an active provider?
As of the registry snapshot, MS. THERESA MARIE WILSON (LICSW) is marked active.
What healthcare role does MS. THERESA MARIE WILSON (LICSW) hold?
Scheduling teams often label MS. THERESA MARIE WILSON (LICSW) under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does MS. THERESA MARIE WILSON (LICSW) list a practice location?
Patients near North Easton, Massachusetts may find MS. THERESA MARIE WILSON (LICSW) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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